Shah, V O, et al., Plasma Metabolomic Profiles in Different Stages of Ckd. Clin J Am Soc Nephrol, 2013. 8(


Metabolon results led to:

  • Validation of the potential for metabolomics to differentiate worsening stages of CKD in this pilot study
  • Identification of potential biomarker candidates that may be mechanistically linked to pathophysiology of CKD

Key metabolomic observations:

  • ADMA and fibrinopeptide A may be potential biomarker candidates of worsening CKD progression
  • CMPF, a uremic toxin, accumulated in plasma with CKD progression
  • Sulfated steroid hormone metabolites were decreased in CKD stage 4 as compared with stage 2

Chronic kidney disease (CKD) is growing in prevalence. Metabolomics was used to determine whether there were unique signatures of worsening stages of CKD (2, 3 and 4) that could serve as potential biomarkers of the progressive stages of CKD. Plasma from 10 non-diabetic men aged 40-52 in each of 3 worsening stages (2, 3 and 4) of CKD were studied. Worsening progression of CKD was associated with altered arginine metabolism, elevated coagulation/inflammation, impaired carboxylate anion transport and decreased adrenal steroid hormone production. Asymmetric dimethylarginine (ADMA) inhibits nitric oxide synthase and therefore limits nitric oxide production potentially contributing to vascular complications. Fibrinopeptide A is a proinflammatory peptide that may reflect a diminished capacity to clear this metabolite concomitant with a decrease in estimated glomerular filtration rate (GFR). Thus ADMA and fibrinopeptide A, both altered from stage 2 to 3 and 3 to 4, may represent useful stage-specific biomarkers.

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